Afib ?

[Elgato]

Yes, yet another thread by Elgato.

I have noticed that some people have had problems with AFIB.

My surgeon said that it happens in 30 to 40 percent of valve recipients, that both mechanical and tissue are equally susceptible and does not matter if
you never had it before surgery. He also said that it is short term and usually only a problem for the first few months.

Could you please comment and share your experiences with it?

What does it feel like and does it mean a trip to the ER or can you just have some meds at home?

Thanks again.

 

[dick0236]

Could you please comment and share your experiences with it?

What does it feel like and does it mean a trip to the ER or can you just have some meds at home?

Thanks again.

Although I have had skipped heart beats or very short erratic beats over the years, I had my first Afib episode about a year ago. It occurred late at nite, after a stressful battle with a cable TV company. I considered the ER, but decided to wait it out 'til morning and went to my PCP who, after an EKG, confirmed the Afib. Since I was already on Warfarin, I was told to "take an extra 25mg Atenolol" and follow up with my Cardiologist in a couple days. A 24 hour Holter showed the heart had returned to normal rhythm and further treatment was not needed.

I have a number of friends who, while not valve patients, experience Afib regularly.....so it does not take heart surgery to trigger Afib....... age is more of a culprit. That's why so much advertising is now being directed to "non-heart valve" patients touting the newer anti-coagulant drugs.

 

[Azzurri]

I had my aortic valve replaced on March 18 and I had two episodes of afib while in the hospital and I have had two episodes during my recovery at home. (I am 47 years old). I've found the episodes to be pretty miserable. My heart beats very erratically and it feels like a runaway train in my chest. It also drains me of any energy and makes it difficult for me to do much of anything. The first time it occurred in the hospital I was cardioverted to go back to a normal rhythm. The second time, they started me on an Amiodorone drip and upped my Metoprolol intake and eventually I went back into rhythm. The docs tell me it's fairly common after heart surgery (about 40%) and that it's more of a "nuisance" than anything else. They tell me that it resolves on its own more than 90% of the time but it could take 4 to 6 weeks before the episodes go away for good. My cardiologist told me that if the episodes don't last very long, I should just take it easy while I have them. If they persist for a long time, I am to go into the emergency room. So far, the two episodes I've had while at home have lasted about 4 hours each so I have not gone in. Hopefully they will be a thing of the past soon.

 

[Mentu]

Hi, again, I also had some concerns about Afib following valve replacement and talked it over with my surgeon. Dr Spann said that some people come to surgery with these problems but that most do not. He explained that one of the critical aspects of AVR is the care with which the surgeon must sew the new valve into place. There is a spot on the wall of the heart near the Aortic Valve called the AV node or AV Conduction Bundle which regulates heartbeat. Should the surgeons needle pierce this area which to the eye looks just the same as the surrounding tissue, the patients heart can loose the ability to regulate heartbeat. It is at this point that one truly begins to realize that there is so much more to heart surgery than the basic facts. Because it is routine for them, it is easy to fail to appreciate the tremendous skill with which our surgeons operate. Only at the end of surgery when the heart is restarted can the surgeon know that damage to the AV Conduction Bundle has occurred. In the event that it has, the surgeon may install a pacemaker. Sometimes it isn't evident for some time that the heart cannot return to a normal rythm and a pacemaker may be installed a few days later.

The good news is that AVR does not usually result in heart rythm disorders. Yes, it can happen but it usually doesn't. One of the things that we accept with AVR is that the problems that can result from the surgery itself are manageable. For me and anyone else facing approaching death caused by our failing valves, the possible side effects of surgery are a very acceptible alternative. The possibility of a rythm problem comes with the territory, so to speak but it is important to always keep in mind that it usually does not happen. These considerations may color our choice of hospital or surgeon but who would accept the alternative of a rapid decline to an early death over surgery that can restore one's health and allow one to live a normal life?

Larry

 

[pellicle]

...He explained that one of the critical aspects of AVR is the care with which the surgeon must sew the new valve into place. There is a spot on the wall of the heart near the Aortic Valve called the AV node or AV Conduction Bundle which regulates heartbeat.

thanks for that, I've been trying to remember what that was called for ages now...

worth reading:
http://en.wikipedia.org/wiki/Atrioventricular_node

 

[AZ Don]

Hi,
After my valve sparing aneurysm repair, I had two episodes of AFib, one which required a trip to the ER where they quickly stopped it with meds, the other was stopped by meds at home. Both occurred within the first two months. Prior to surgery I would sometimes have brief palpitations (a few seconds), and they seemed more frequent or noticeable prior to the surgery, but I never had Afib which to me was like the palpitations only continuing for hours. It felt to me like my heart was dancing. It isn't painful but it is a little unsettling. My heart rate monitor had a difficult time measuring my HR during Afib and when it did it showed 140 - 160 beats per minute. At the hospital the machine showed over 220. Not that it was actually beating that fast, with the Afib, I think they simply can't get an accurate measurement. Since then my Dr. provided me a list of things besides meds that may stop an episode of Afib, but I haven't had the chance to try them out.

Ways to stop A-Fib:
wash face with cold water and hold breath. triggers diving reflex http://en.wikipedia.org/wiki/Mammalian_diving_reflex
Cough
Rub neck by artery
Bear down - vasalva maneuver

Although Afib is not uncommon following surgery, I think it is rather uncommon for it to continue after the first couple months. Not only have I not had any more episodes of Afib, I almost never have the palpitations either.

 

[epstns]

Again - I had some afib, both immediately following surgery and during the month immediately after. I'm one of the "lucky" ones who had rhythm problems post op. In my case, it had nothing to do with the skill and care of the surgeon. Mine had to do with the amount of calcified tissue the surgeon had to remove to implant my new valve. After the implant, my heart would not return to any sort of normal rhythm. I had afib, vtach, tachycardia, bradycardia and even long (20 seconds or more) pauses. About 5 days post-op, we decided that my heart was not likely to return to any semblance of normal sinus rhythm, so I opted for the pacemaker. Even the pacemaker is not a big deal, compared to where I would be had I not opted for valve surgery, so don't worry about the "what-if" situations like mine. Life is good.

When I did have afib, mine was rather profound. The last time I had a documented bout of afib I was in the audience at a play, just one month post-op. When the afib hit, it was most definitely nap time. I simply slept through most of the second act of a boring play. When I awoke, I felt fine. No lasting issues, as that was over 3 years ago and the only other documented period of afib was when I was in the ER with a pinched nerve in my back, in great pain. (I call mine "documented" bouts of afib, because my pacemaker records the date, time and duration of each incident for the EP to evaluate.)

My mother had afib for a number of years. It didn't slow her down until her bradycardia got bad enough that they implanted a pacemaker for her. We then called her "the Energizer Bunny" because she could just keep going and going and going. . .

 

[tom in MO]

I had afib and did not know it. Immediately after surgery, at home I'd listen with my thrift store stethescope. It was irregular and scary. I had no symptoms. I stopped listening thus no more problem.

Since then, I've listened about 3 months later and it was like a clock and still is.

 

[joanpieroni]

Afib

Afib

Yes, yet another thread by Elgato.

I have noticed that some people have had problems with AFIB.

My surgeon said that it happens in 30 to 40 percent of valve recipients, that both mechanical and tissue are equally susceptible and does not matter if
you never had it before surgery. He also said that it is short term and usually only a problem for the first few months.

Could you please comment and share your experiences with it?

What does it feel like and does it mean a trip to the ER or can you just have some meds at home?

Thanks again.

I had VR March 27th, I was fine the first week after surgery but then my heart rate went up to 156, I went to the ER and they got it down with Cardizem in my IV. They kept me overnight for observation. A week passed and it went up again, same thing 156 so I went back to the ER. As soon as I got there they did a quick EKG and said it was Atrial Flutter. The same med brought it down. I went home only to return 24 hrs later but my heart rate was up to 162. so I was kept and an ablaision was done to get rid of the flutter and my heart rhythm is perfect now. I am so glad that was done. I feel so much better.

 

[clay_from_nj]

No afib here, but some pretty scary runs of PVCs, which thankfully, are diminishing over time.

 

[ChicagoMammy]

I have had a fib several times over the last nine years. I can feel the palpitations and know what's wrong immediately. I usually wait 15 minutes before going to the ER to see will it stop. I used to get an hour or two where I'd still feel fine and then start feeling dizzy and back pain. Since my last pregnancy (2.5 years ago) I now feel those symptoms straight away. If I was symptomless I would wait longer to go to the ER but for me they like to try to get me back into sinus rhythm ASAP. The longest has been four days. I was fifteen minutes away fm being cardioverted when I went back into sinus on my own.

Last surgery (7.5 years ago) I had a lot of palpitations for weeks afterwards. Mostly PVCs but probably some tiny runs of a fib and flutter. This time I've had a minimal amount. Less than pre-surgery which has been great.

 

[Nupur]

post op Afib seems to be common, but seems like something that goes away within a few months, that's very re-assuring. i am in the waiting room, but my left atrium is borderline enlarged, so I am at risk of afib. If I exert too much (walking uphill in sun for example) I feel a flutter and heart pounding sometimes, but it goes away quickly. I have never had documented Afib, but I have started taking a baby aspirin upon my cardio's advice to be safe. I was told that the Afib poses a risk of throwing clots, but is otherwise not life threatening in any way.